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LVET is an infrastructure organisation representing areas within the voluntary and community sector, your feedback is vital for us to improve the way we do things in the future.  The purpose of the survey is to check we are listening to our members. Delivering what you need and expect, learn about the areas where you think we are doing well, and areas where you feel we could improve. 

We have an LVET away day in January and these survey results will help shape our plan going forwards, so it is important we know what is important to you. Following the away day, we will share progress and keep you updated along the way. 

Information shared with us is anonymous: unless you would like to include your contact details at the end for us to contact you directly to gather any further information if required. If you choose to share your email contact with us, it will only be used for the purposes of responding to this survey.

You can share your thoughts here.

Lincolnshire Community Foundation

Household Support Fund launched in South Kesteven

Lincolnshire Community Foundation is delighted to be working with South Kesteven District Council to provide vital funds across the District.

Grants of up to £300 will be given to individuals and families, who have not received any cost of living support across the District. Funding originates from UK Government via the South Kesteven Household Support Scheme.

We recognise there are many households across the area who find themselves in financial hardship or just about managing, but do not qualify for any other benefit or income support. Support will be given predominantly in the form of vouchers for food, energy (no cash grants are given).

Katie Littlewood, Lincolnshire Community Foundation, Grants Manager for this fund said: “The Foundation has been invited to continue working with South Kesteven District Council to support people who haven’t been entitled to Government’s cost of living payments. We understand what a difficult time this is for many and will do what we can to help.”

Head of Service (Revenues, Benefits, Customer and Community), Claire Moses said: “This fund aims to support those on a low income, have limited savings, and are particularly at risk due to factors such as disabilities or caring for young children. I would urge anyone struggling, even if they are not on any benefits, and who feels they might be eligible and needs help with their application to get in touch with the Community Foundation.”

Applications can be made via the Lincolnshire Community Foundation Website www.lincolnshirecf.co.uk from 2^nd October until 18^th March 2024. Those without internet access should contact the Grants team on 01529 305825 or email katie@lincolnshirecf.co.uk

Notes to editors: About Lincolnshire Community Foundation

Lincolnshire Community Foundation is the county’s leading independent grant maker founded in 2002 and part of the network of 47 Community Foundations across the UK delivering positive outcomes for People and Places. Our work is grounded in the value of #ChangeNotCharity. The Foundation has, since its inception, distributed upwards of £18m with emphasis on small grants delivering a big difference. https://lincolnshirecf.co.uk

Lincolnshire Community Foundation

Lincolnshire Community Foundation are delighted to be working with West Lindsey District Council to provide vital funds across the District. Grants of up to £300 will be given to individuals and families, who have not received any cost of living support across the District. Funding originates from UK Government via the West Lindsey Household Support Scheme.

We recognise there are many households across the area who are finding themselves in financial hardship or just about managing, but do not qualify for any other benefit or income support. Support will be given predominantly in the form of vouchers for food, energy (no cash grants are given).

Katie Littlewood, Lincolnshire Community Foundation, Grants Manager for this fund says:

The Foundation has been invited to continue working with West Lindsey District Council to support people who haven’t been entitled to Government’s cost of living payments. We understand what a difficult time this is for many and will do what we can to help.

Cllr Trevor Young, Leader of West Lindsey District Council says:

West Lindsey is pleased to be working with the Lincolnshire Community Foundation to support the delivery of the Housing Support Fund applications’

Applications can be made via the Lincolnshire Community Foundation Website www.lincolnshirecf.co.uk from 11^th August 2023 until 18^th March 2024. If you do not have access to the website, please contact the Grants team on 01529 305825 or email katie@lincolnshirecf.co.uk

Notes to editors

About Lincolnshire Community Foundation

Lincolnshire Community Foundation is the county’s leading independent grant maker founded in 2002 and part of the network of 47 Community Foundations across the UK delivering positive outcomes for People and Places. Our work is grounded in the value of #ChangeNotCharity. The Foundation has, since its inception, distributed upwards of £18M with emphasis on small grants delivering a big difference.  https://lincolnshirecf.co.uk/

Lincolnshire County Council is coordinating a submission to the Department of Health and Social Care’s Accelerating Reform Fund. 

They already have some ideas submitted by voluntary organisations and from care providers. For example: Wraparound support for people when they go home from hospital; a deep clean and maintenance service; a review and redesign of the Carers Emergency Response Service; an approach to carers for people with Learning Disabilities as they age, an expansion of information and advice services; or an extension of the Trusted Assessor system. 

Can you add value to the suggestions? Do you have ideas of your own that would speed up or scale the adoption of innovative practice? Or that will build capacity in adult social care in Lincolnshire? 

If you have ideas or want to add to existing ideas get in touch with LVET via paul.gutherson@lvet.org or contact Joanne.Osborn@lincolnshire.gov.uk  as soon as possible. 

At this point all that is needed is a high level outline describing the idea, the outcomes you hope to achieve, the challenges you might face, what you will measure to prove its impact and what teh overall impact will be.

Your ideas should meet one of the 12 priorities set by the Minister of State for Care: 

Priority 1: community-based care models such as shared living arrangements 

Priority 2: supporting people to have greater control over their care options, such as by using digital tools to self-direct support or communicate needs and preferences 

Priority 3: investment in local area networks or communities to support prevention and promote wellbeing, enabling people to age well in their communities 

Priority 4 (focusses on unpaid carers): ways to support unpaid carers to have breaks which are tailored to their needs 

Priority 5: digital tools to support workforce recruitment and retention, for example through referral schemes 

Priority 6: develop and expand the impact of local volunteer-supported pathways for people drawing on care and support 

Priority 7 (focusses on unpaid carers): ways to conduct effective carer’s assessments with a focus on measuring outcomes and collaboration 

Priority 8 (focusses on unpaid carers): services that reach out to, and involve, unpaid carers through the discharge process 

Priority 9: digital workforce development and market shaping tools with capability to map, strengthen and grow local workforce capacity relative to system demand 

Priority 10: social prescribing to connect people with information, advice, activities and services in the community 

Priority 11 (focusses on unpaid carers): ways to better identify unpaid carers in local areas 

Priority 12 (focusses on unpaid carers): ways to encourage people to recognise themselves as carers and promote access to carer services.

The below is taken from the foreward of the Summary. Please follow the links for the full article.

This year has been a turbulent one for health and social care.

In addition to the ongoing problem of ‘gridlocked’ care highlighted in last year’s State of Care, the cost of living crisis is biting harder for the public, staff, and providers – and workforce pressures have escalated. This combination increases the risk of unfair care – where those who can afford to pay for treatment do so, and those who can’t face longer waits and reduced access.

Adult social care providers are facing increased running costs, including food and electricity, with some struggling to pay their staff a wage in line with inflation, which affects recruitment and retention. This is likely to have an impact on people, both in the quality of care they receive and in providers’ ability to re-invest in care homes – data from our Market Oversight scheme shows that care home profitability remains at historically low levels.

Local authority budgets have failed to keep pace with rising costs and the increase in the number of people needing care. As adult social care places funded by a local authority are often less profitable, there is the risk that people who live in more deprived areas, and are more likely to receive local authority-funded care, may not be able to get the care they need.

Some people who pay for their own care at home have had to cut back on visits to support their basic needs. One homecare provider told us that, due to the cost of living crisis and increased fuel prices, it had to increase the rates charged. Because of this, some people had to reduce their care visits to a minimum, which had an impact on their quality of life.

Workforce pressures, already a huge challenge, have further intensified, with ongoing industrial action by NHS staff unhappy with pay and conditions. The number of people on waiting lists for treatment has grown to record figures and in the face of longer waits, those who can afford it are increasingly turning to private healthcare. Research from YouGov shows that 8 in 10 of those who used private health care last year would previously have used the NHS, with separate research showing that 56% of people had tried to use the NHS before using private healthcare.

The danger is that the combination of the cost of living crisis and workforce challenges exacerbate existing heath inequalities, increasing the risk of a two-tier system of health care. People who cannot afford to pay could end up waiting longer for care while their health deteriorates. Our adult inpatient survey, based on feedback from over 63,000 people, found that 41% felt their health deteriorated while they were on a waiting list to be admitted to hospital.

People may also be forced to make difficult financial choices. We heard from someone who receives benefits who resorted to extracting their own tooth because they were unable to find an NHS dentist. They then had to pay £1,200 on a credit card for private treatment, doing without household essentials until the debt was paid.

While the publication of the NHS Long Term Workforce plan has been a positive step in addressing workforce pressures, implementation will be challenging – particularly without a social care workforce strategy to sit alongside it. We continue to call for a national workforce strategy that raises the status of the adult social care workforce and ensures that career progression, pay and rewards attract and retain the right professional staff in the right numbers. It is encouraging that Skills for Care has made this an area of focus.

In our inspection activity, we have continued to take a risk-based approach this year, focusing our inspection activity on those core services that, nationally, are operating with an increased level of risk, and on individual providers where our monitoring identifies safety concerns. Ratings data shows a mixed picture of quality, with a notable decline in mental health and ambulance services.

We have continued our focused programme of maternity inspections, with the overarching picture emerging of a service and staff under huge pressure. Ten per cent of maternity services are rated as inadequate overall, while 39% are rated as requires improvement. Safety and leadership remain particular areas of concern, with 15% of services rated as inadequate for their safety and 12% rated as inadequate for being well-led.

While it has been encouraging that all maternity units inspected so far have adjusted the level of consultant cover to meet recommendations made in the Ockenden report, the cover model is often fragile, with rotas relying on every consultant being available. We have seen examples of services taking action to manage staff shortages safely – but we have also seen issues with governance and lack of oversight from trust boards, delays to care and lack of one-to-one care during labour, as well as poor communication with women and difficult working relationships between staff groups.

Alongside our programme of maternity inspections, we have commissioned a series of interviews with midwives from ethnic minority groups to explore their experiences of working in maternity services and their insights into safety issues. A common theme from these interviews was that care for people using maternity services is affected by racial stereotypes and a lack of cultural awareness among staff. One midwife told us; “The NHS is amazing, but it was built by white people for white people. We need to adapt, because now we have a diverse population and workforce.

Access to and quality of mental health care also remain key areas of concern, with gaps in community care continuing to put pressure on mental health inpatient services and many inpatient services struggling to provide beds. This, in turn, is leading to people being cared for in inappropriate environments – often in emergency departments. One acute trust told us that there had been 42 mental health patients waiting for over 36 hours in the emergency department in one month alone. When people do get a bed in a mental health hospital, the quality of care is often not good enough. Safety continues to be an area of concern, with 40% of providers rated as requires improvement or inadequate for safety.

Recruitment and retention of staff remains one of the biggest challenges for the mental health sector, with the use of bank and agency staff remaining high and almost 1 in 5 mental health nursing posts vacant. We’ve raised concerns that staffing issues in mental health services are leading to the over-use of restrictive practices, and we’ve worked with our expert advisory group for autistic people and people with a learning disability to develop a clearer and stronger position on these practices, including restraint, seclusion, and segregation. We expect all providers of health and social care to recognise restrictive practice and to actively work to reduce its use.

Many of the challenges described in this year’s State of Care are to some degree caused by a lack of joined-up planning, investment, and delivery of care. Integrated care systems present the opportunity of bringing together local health and care leaders with the populations they support to understand, plan, and deliver care at a local level. This would, in time, move some of the focus of care away from big institutions and towards local and self-care provision, with autonomy to act on the needs of a local population and an increased focus on preventing poor health – not just treating it.

However, in our first look across local care systems, we found that while all systems have some equality and health inequalities objectives, not all these plans have timeframes and measures. All systems need clear and realistic goals, and support to achieve these, that reflect how they will address unwarranted variations in population health and disparities in access, outcomes, and experience of health and social care.

This opportunity must be grasped to ensure fairer care for everyone – so people get the care they need, not just the care they can afford.

Ian Trenholm
Chief Executive

Ian Dilks OBE
Chair

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Summary

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State of Care 2022/23

Contents

• State of Care 2022/23
• Foreword
• Summary
• Access to care
• Quality of care
• Inequalities
• Deprivation of Liberty Safeguards
• The health and care workforce
• Systems